REALM Preliminary Literature Review Now Available The REopening Archives, Libraries, and Museums (REALM) Project is conducting literature reviews to help define the scope of the project’s research and the information needs of libraries, archives, and museums. The first review has been completed by researchers at Battelle; this document offers a set of findings from publicly available scientific literature. This information helps to set the context for the laboratory research that is being conducted during the REALM Project. This preliminary review focused on studies of virus attenuation on commonly found materials, such as paper, plastic, cloth, and metal; methods of virus transmission; and effectiveness of prevention and decontamination measures. A fuller, more systematic literature review is also in progress and will be released later in June. As you read this preliminary literature review, keep in mind a few key points: 1. The research and information captured in the findings include both peer-reviewed and non-peer- reviewed studies. In the interest to publish emerging research related to the COVID-19 pandemic as quickly as possible, publication has been expedited rather than waiting for time intensive peer review. 2. The studies included in the review have been conducted by different researchers, under different conditions, likely using different concentrations —and possibly sources—of the virus. This makes it difficult, if not impossible, for a reviewer to make a straight comparison across studies; and, interpreting the results may be challenging for readers without a science background. The systematic review which will follow this preliminary review will include a synthesis and more analysis to help with the interpretation; that review will be released later in June. 3. The review includes findings for industries, such as health care, that operate under considerably different constraints and risk factors than do libraries, archives, and museums, (abbreviated LAMs). However, in this preliminary search, it was important to consider a broad range of available research to determine what may be applicable to LAM operations and identify what research gaps exist. The research captured in the review does not represent recommendations or guidance for LAMs; but, commonalities with other fields and industries may be found as the research proceeds, and the project will continue to monitor the science literature for emerging science-based information that relates to LAM operations. The project team will continue to collect and review published literature related to COVID-19 and share out those findings with the LAM community. Preliminary Literature Review for the Natural Attenuation of SARS-CoV-2 as a Decontamination Approach Prepared For: OCLC and Institute of Museum and Library Services (IMLS) OCLC 6565 Kilgour Place Dublin, OH 43017 14 May 2020 Submitted by: Battelle 505 King Ave Columbus, Ohio 43201-2696 This document was sponsored by and prepared under auspices of Battelle Contract Number: CON00031948 This preliminary literature review synthesizes various studies and data; however, the scientific understanding regarding COVID-19 is continuously evolving. This material is being provided for informational purposes only, and readers are encouraged to review federal, state, tribal, territorial, and local guidance. The authors, sponsors, and researchers are not liable for any damages resulting from use, misuse, or reliance upon this information, or any errors or omissions herein. Table of Contents 1. Introduction ...................................................................................................................... 2 1.1. Purpose of Literature Review .......................................................................................... 2 2. Methods ........................................................................................................................... 2 3. Findings ........................................................................................................................... 2 3.1. Spread of SARS-CoV-2 through public library operations ............................................... 2 3.1.1. Aerosol Transmission ...................................................................................................... 2 3.1.2. Other Routes of Transmission ......................................................................................... 4 3.2. Survival of SARS-CoV-2 on material surfaces through environmental attenuation ......... 5 3.3. Effectiveness of Prevention and Decontamination Measures ......................................... 8 3.3.1. Thermal Treatment .......................................................................................................... 9 3.3.2. Personal Protective Equipment (PPE) ............................................................................. 9 3.3.3. Hand Hygiene ................................................................................................................ 10 3.3.4. Plastic Barriers ............................................................................................................... 10 3.3.5. Light Exposure ............................................................................................................... 10 3.3.6. Sodium dichloroisocyanurate ......................................................................................... 11 3.3.7. Ventilation and open space ........................................................................................... 11 3.3.8. Surface cleaners and disinfectants ................................................................................ 11 4. Conclusion ..................................................................................................................... 12 5. References ..................................................................................................................... 13 Use or disclosure subject to title page restrictions SARS-CoV-2 Literature Review - i 1. Introduction 1.1. Purpose of Literature Review Battelle is conducting a literature review to gather and evaluate existing research about SARS- CoV-2 (the virus that causes COVID-19) related to the following research questions: 1. How does the virus spread through public library general operations? 2. How long does the virus survive on material surfaces through environmental attenuation? 3. How effective are various prevention and decontamination measures that are readily available to public libraries in the near term? 2. Methods Battelle is conducting a systematic literature review, but first Battelle performed an organic, targeted search of the research landscape as an exploratory preliminary step. Battelle research staff searched research tools such as PubMed, WorldCat Discovery, and Google Scholar to identify scholarly articles that address the novel coronavirus SARS-CoV-2 in terms of the research questions above. As such, emphasis was given to peer-reviewed articles that directly discussed SARS-CoV-2 in terms of its survivability on surfaces, effective prevention and decontamination measures, and how the virus may spread through library operations (especially aerosol transmission). However, due to the emerging nature of the research topic and the amount of time typically required for publication of rigorous scientific studies, in many cases relevant articles found are those that have been published online in “pre-print,” “letter to the editor,” “early release,” or other sub-optimal forms. In these cases, the articles have not undergone the traditional scholarly peer review needed to vet the scientific quality of research methods and findings, so the findings from these articles must be approached with considerable caution where present. 3. Findings The findings of the preliminary search are presented below, organized by research question. 3.1. Spread of SARS-CoV-2 through public library operations Two primary types of transmission available in the literature search were aerosol transmission and the transmission of SARS-CoV-2 near people who have been infected with the virus. 3.1.1. Aerosol Transmission In “Master Question List for COVID-19 (caused by SARS-CoV-2),” a literature review published by Department of Homeland Security Science and Technology Directorate, it was concluded that, “If aerosolized intentionally, SARS-CoV-2 is stable for at least several hours” (p. 12). Use or disclosure subject to title page restrictions SARS-CoV-2 Literature Review - 2 In another study, airborne transmission was found to be minimal, though this may have been due to a small sample size or the specific air filtration system in place. Cheng et al. (2020) reported that, in an “airborne infection isolation room” in a Hong Kong hospital, an experienced infection control nurse collected air samples 10 cm from the mouth of a patient diagnosed as infected with SARS-CoV-2 as the patient engaged in four types of respiratory activities: breathe normally, breathe deeply, speak continuously, and cough continuously, while putting on and taking off a surgical mask. The patient's nose/throat swabs were said to have a "moderate" viral load of 3.3 x106 copies per mL and the saliva was 5.9 x106 copies per mL. The air samples were undetectable for SARS-CoV-2 RNA. The authors said they could not make a definitive conclusion based on having one patient sample, but they attributed the lack of detectable virus in the eight air samples to the use of air cleaning in the isolation rooms (12 air